Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A24150 | CA |
N | 2080A0000X | Adolescent Medicine | A24150 | CA |
N | 2080P0201X | Pediatric Allergist | A24150 | CA |
NPI | 1780690636 |
---|---|
Provider Name | Duke D Kim |
First Address | Fountain Valley, CA 92708-3207 |
Second Address | Mission Viejo, CA 92691-6407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 26/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A82951 | (02) | CA |